What do clinical pathologists do?

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quant

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Pardon my naivete....but what is it exactly that clinical pathologists do?....I have been trying to figure out what is involved in the job description and am getting the feeling that they are more of administrators than anything else. I might be totally wrong but id be grateful for an insight into the life of a clinical pathologist.What are the pros and cons of being one? Also, is it a very anemic market out there for a clinical pathologist?How good are prospects in academics?.....I have an interest in immunopathology but i just wanted to know.Current residents and Pathologists....any opinions?
Thanks all for your time
Regards
Quant
 
Clinical pathologists sit in their office and work on presentations, research, teaching, or trying to figure out how to streamline lab functions and save money. Occasionally, a lab issue will come up (like mislabeled specimens, quality control issues, machine breaking, bizarre results, etc) that they have to deal with.

What they are paid to do is to supervise the lab. I.E. make sure everything functions smoothly and efficiently. They supervise protocols and determine which tests are appropriate. There are thousands of tests out there, and the lab directors have to decide whether it is cost effective to provide a test, how often to provide it, and how to report the results.

Like ANA for example - there are different ways to run the test - some are automated, some not. Which provides the best results? There are also many esoteric tests which are rarely ordered, thus if it is not worth the expense and expertise to provide that test, the lab will contract with another facility (like Mayo or ARUP, big places) who will run it - this happens a lot with certain molecular tests and rare disease assays.

Most academic CP people spend a lot of time on research. Some of the labs, particularly chemistry and micro labs, are run by PhDs (not MD/PhDs).

Immunopath is a fairly specific field and generally limited to researchers who also do some signout in their time. Immunopath issues include reading protein electrophereses, certain immunology tests like anti-GBM or difficult ANAs. Because a lot of CP is automated or done by techs who are experts in a specific test, the pathologist doesn't do a lot of the work. They are, however, responsible for it all.

In terms of day to day CP residency - at first you spend time learning about all the assays, tests, methods, etc. Eventually you work your way up to solving problems on your own and helping develop methods and procedures.

Anemic job market? Don't know. Don't think so, but if your only training is in clinical path there will not be a lot of job opportunities outside of specialized areas. Clearly, if you are an expert in microbiology and CP only trained you could find a job if you were good enough. But many average community jobs don't have jobs specifically for CP folks. You cross cover. This is why community jobs generally prefer people trained in both AP and CP.

What other questions do you have?
 
Thanks, guys; this has been helpful. I'm interested in doing a hemepath fellowship after residency--anyone know whether programs tend to prefer AP/CP trained folks over CP only for this? Choosing between CP only and AP/CP is tough for me, because although I think I would miss the more interesting aspects of AP, if I can avoid the long hours of surg path, so much the better (we have a 13-month old at home). Any thoughts?
 
skoller said:
Thanks, guys; this has been helpful. I'm interested in doing a hemepath fellowship after residency--anyone know whether programs tend to prefer AP/CP trained folks over CP only for this? Choosing between CP only and AP/CP is tough for me, because although I think I would miss the more interesting aspects of AP, if I can avoid the long hours of surg path, so much the better (we have a 13-month old at home). Any thoughts?
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Hi Skoller! I'm applying to CP only programs after having a bunch or long discussions with some of the Path faculty at my school. Basically, what I've concluded is that it depends on who you talk to about AP/CP verses CP alone. If you ask an AP/CP attending they'll usually recommend doing both cause it's only 1 more year, you obtain a better understanding of the pathophys and you are more marketable after residency.

If you ask a CP only trained person, they generally imply that CP alone is okay, but it may be difficult to find a job in the city of your choice if you only do CP. If you want to run a lab, it was suggested to get an MBA, although you don't NEED and MBA to run the lab. Otherwise go for a fellowship.

So, it one sentence, to answer your question...it seems as though you can make out alright with CP only depending on you career endpoint. This of course is coming from a CCIV so take it with a grain of salt! 😎
 
I would strongly suggest you talk to some hemepath people before embarking on a CP only residency if your goal is a hemepath fellowship - from what I have heard they prefer people with AP experience.

In fact, some people do hemepath fellowships with AP only training.

I may be wrong that people don't jump from CP only to hemepath fellowship - they probably do. But I think some programs may not accept this pathway...just fyi.
 
A lot of what CP pathologists do depends on what training they have: microbiology, transfusion medicine, heme, chemistry, etc. They do have quite a bit of managerial duty, seemingly more so sometimes than the AP folks.

Unless you can't stand AP, do AP/CP. You can do a CP only field after residency but it's good to have the AP background, especially in hemepath; you will have to look at lots of tissue other than bone marrow to determine if something is a lymphoid process or not. It's good to have some AP background.
 
Thanks for all the input. I did speak with my hemepath mentor about this and she offered pretty much the same advice as Yaah and Doctor B. MS05, good luck with CP--I think I probably will go for AP/CP after all.
 
Wow, I know this is a really old thread, but I hope y'all will forgive me for bumping it up; there don't seem to be any newer ones. In a nutshell, I'm interested in learning more about clinical chemistry, and particularly what kind of research is done in that field. I came into med school already having a PhD in organic chem, so I'd like to find some way to put it to good use. Appreciate any thoughts any of you might have on research opportunities for a chemist in path.
 
I would answer this because I just produced my corporation's invoice for April in terms of Clinical Path Services but Im too lazy atm. Been really getting into my new game: Vanguard.

Necromancers FTW!
 
QofQuimica said:
Wow, I know this is a really old thread, but I hope y'all will forgive me for bumping it up; there don't seem to be any newer ones. In a nutshell, I'm interested in learning more about clinical chemistry, and particularly what kind of research is done in that field. I came into med school already having a PhD in organic chem, so I'd like to find some way to put it to good use. Appreciate any thoughts any of you might have on research opportunities for a chemist in path.
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Well, I think you spend a lot of time (if you run the lab) working out assays and crunching numbers, etc. But I suppose anything you can think of is a possibility. Improving assays, combining assays, developing assays or new techniques, etc etc. Most of clinical chem in pathology is automated, so the chemistry lab director doesn't do a lot of chemistry. They do a lot of politicking as they interact with other department heads (i.e. we want this test up and running) and department administration, etc etc.

Basically if you bring in your own money you can do whatever you want in pathology.
 
yaah said:
Well, I think you spend a lot of time (if you run the lab) working out assays and crunching numbers, etc. But I suppose anything you can think of is a possibility. Improving assays, combining assays, developing assays or new techniques, etc etc. Most of clinical chem in pathology is automated, so the chemistry lab director doesn't do a lot of chemistry. They do a lot of politicking as they interact with other department heads (i.e. we want this test up and running) and department administration, etc etc.

Basically if you bring in your own money you can do whatever you want in pathology.
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Hmm, that doesn't sound like very much fun. I just found out that my school has an elective in forensic path though; THAT sounds like it would be interesting. 🙂
 
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